United States Air Force

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Legal business name

UNITED STATES AIR FORCE

Practice address

4250 Griffiss Ave
Nellis AFB, NV 89191-7018

Phone

(702) 404-1142

NPI assigned

Jul 27, 2009

Last updated

Jul 27, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fred J Parker

Title

Idmt/SSGT

Phone

(702) 404-1142

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Freda Ann Henderson

  • Independent Duty Medical Technicians
  • Nellis AFB, NV
  • NPI 1124253554
  NPD (past)
• Nicanor Mercado Laudato Jr., IDMT

  • Independent Duty Medical Technicians
  • Nellis AFB, NV
  • NPI 1851527279
  NPD (past)
• Dejnekki Ayana Peyton

  • Independent Duty Medical Technicians
  • Nellis AFB, NV
  • NPI 1134357163
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1952532814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 GRIFFISS AVE",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891917018",
            "telephone_number": "702-404-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 GRIFFISS AVE",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891917018",
            "telephone_number": "702-404-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATES AIR FORCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "IDMT/SSGT",
        "authorized_official_telephone_number": "702-404-1142"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle L Turner, LCSW
• Jaime Patricia Umberger, DO
• Scott Tracy Underwood, LCSW
• Timothy R Underwood, PSY.D
• Ryan R. Union, RD
• Kiara Valencia, CADC
• Matthew Vanderhoek, M.D.
• Lucas R Vandermyde, DO
• Seth Joseph Vanderveer, DO, RHMSUS, CSCS
• Jenny Vang, PHARMD

• Independent Duty Medical Technicians in Nellis AFB, NV
• Providers in Nellis AFB, NV by specialty
• Independent Duty Medical Technicians in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.